Handle for surgical instruments

ABSTRACT

A handle for surgical instruments that has a “wishbone” configuration. In one embodiment, the instrument is provided with a ratchet mechanism allows two operating handles to be locked in a predetermined position (for example, when the surgical instrument that is maneuvered is in use) or to move relative to each other when the ratchet is partially or fully released (for example, when the surgical instrument that is maneuvered is not in use). In another embodiment, the instrument is provided with a rotary gear mechanism.

CROSS-REFERENCE TO RELATED APPLICATIONS

This application claims the benefit of U.S. Provisional Application Ser.No. 60/763,914, filed on Feb. 1, 2006, the entire disclosures of whichis incorporated by reference herein.

FIELD OF THE INVENTION

The present invention relates to the field of surgery and, inparticular, to a novel instrument handle for aiding in manipulatinganatomical tissue or suture during endoscopic surgical procedures.

BACKGROUND OF THE INVENTION

Endoscopic surgical procedures typically involve techniques andinstruments that require access to a surgical work site that is within apatient's body. Access is normally provided through one or more portalsformed directly in the patient's body or through one or more cannulasinserted into the patient's body through small incisions. A chosensurgical procedure is carried out by a surgeon through the use ofelongated instruments inserted through these cannulas to reach andconduct various surgical procedures at the work site.

Since the work site is only accessible through a small portal orcannula, it is very difficult to manipulate tissue or tie sutures withinthe body. Because only a small incision is made during endoscopicsurgery, it is also often difficult to grab small regions of tissue andto simultaneously or subsequently apply a desired tension on the tissue,either in a direction toward or away from the arthroscopic portal.Further, manipulation of anatomical tissue at the work site duringendoscopic surgeries frequently requires simultaneous use of additionalinstruments that are needed during various surgical steps such ascutting or removing tissue, or suturing or tying knots.

Accordingly, a need exists for an improved handle for surgicalinstruments that allows controlled tissue manipulation and retraction,as well as controlled manipulation of suture or other material elementsthat are employed during or in conjunction with endoscopic surgeries. Aneed also exists for surgical instruments (such as graspers, punches orscissors, among others) that are stable during arthroscopy and maintainthe lifting/retracting orientation desired by the surgeon, withoutaccidental slipping or shifting and with minimal soft tissue edema tothe patient. Surgical instruments with a handle having an improveddesign that allows a surgeon to grip the handle ergonomically and toeffectively maneuver tissue or adjacent structures are also needed.Instruments with a simplified actuating mechanism which facilitates useof the instruments during surgery are further needed.

SUMMARY OF THE INVENTION

The present invention provides an improved handle for surgicalinstruments that has a “wishbone” handle configuration. In oneembodiment, the handle is provided with a ratchet mechanism that allowstwo operating handles to be locked in a predetermined position (forexample, when the surgical instrument that is maneuvered is in use) orto move relative to each other when the ratchet is partially or fullyreleased (for example, when the surgical instrument that is maneuveredis not in use).

The ratchet may be actuated by an actuating mechanism that is located onthe handle and that may include, for example, a mechanical thumb leveror trigger connected to the shaft of the instrument. The mechanicalthumb lever or trigger is moveable between a first position when theratchet is “locked” or “closed,” an intermediary position when theratchet is “partially-open,” and a forward position when the ratchet is“fully-open” or “released.” When the trigger is pushed down and/or movedforward, an end effect assembly of the instrument (for example jaws of acapsular punch or of a suture retriever) is maneuvered as desired. Inthis manner, the motion of the ratcheting mechanism including themechanical thumb lever located on the instrument handle is translatedthrough a connecting rod to urge the end effector assembly of theinstrument into “open” or “closed” positions.

In another embodiment, the instrument is provided with a rotary gearmechanism for translating closure force on the handle into rotary motionof a shaft which, in turn, effects rotary motion at the distal(operating) end of the instrument.

Other features and advantages of the present invention will becomeapparent from the following description of the invention, which refersto the accompanying drawings.

BRIEF DESCRIPTION OF THE DRAWINGS

FIG. 1 illustrates a perspective view of an instrument having a handleaccording to a first embodiment of the present invention;

FIG. 2 illustrates a partial view of the instrument of FIG. 1 with theratchet in the “locked” position;

FIG. 3 illustrates a partial view of the instrument of FIG. 1 with theratchet in the “partially-released” position;

FIG. 4 illustrates a partial view of the instrument of FIG. 1 with theratchet in the “fully-released” position;

FIG. 5 illustrates a perspective view of an instrument having a handleaccording to a second embodiment of the present invention with a rotarygear mechanism;

FIG. 6 illustrates a cross-sectional partial view of the instrument ofFIG. 5; and

FIG. 7 illustrates a top view of the instrument of FIG. 5.

DETAILED DESCRIPTION OF THE PREFERRED EMBODIMENTS

The present invention provides surgical instruments for endoscopicsurgeries having an improved handle design, namely a “wishbone”configuration. The “wishbone” configuration of the handle allows asurgeon to grip the handle ergonomically and to effectively maneuvertissue or suture during surgery.

In one embodiment, the handle of the present invention is provided witha ratchet mechanism allows two operating handles having a “wishbone”configuration in a plier-type arrangement to be locked in apredetermined position (for example, when the surgical instrument is inuse) or to move relative to each other when the ratchet is partially orfully released (for example, when the surgical instrument is not inuse).

Referring to the drawings, where like elements are designated by likereference numerals, FIGS. 1-4 illustrate a first exemplary embodiment ofa surgical instrument 100 provided with a handle 50 and ratchetmechanism 40 of the present invention. The surgical instrument 100 ofFIGS. 1-4 may be employed in many surgical procedures, non-limitingexamples including manipulating and retrieving suture, or grasping,punching or cutting tissue during surgery.

As illustrated in FIG. 1, the surgical instrument 100 includes handle50, a shaft 20 having a proximal end 21 and a distal end 23, and anactuating mechanism 30 located on the handle and in communication with aratchet mechanism 40. The actuating mechanism 30 is mechanicallyconnected to the distal tip 23 and, when actuated, causes movement ofthe ratchet mechanism 40, which in turn actuates end effector assembly10. In the exemplary embodiment shown in FIG. 1, the end effectorassembly 10 comprises a pair of hinged jaws 18 that pivotably rotatebetween an open or closed position. However, the invention is notlimited to this exemplary embodiment and the end effector assembly 10may be part of any surgical instrument (for example, scissors, punchesor graspers, among others) that requires manipulation through a handle,such as handle 50 of the present invention.

FIGS. 2-4 illustrate in more detail the actuating mechanism 30 and theratchet mechanism 40 which are part of handle 50 of the presentinvention. The actuating mechanism 30 comprises a mechanical lever ortrigger 33 provided with a cam 37, a spring 25 and an inner rod or shaft(not shown). Shaft 20 of the instrument 100 houses the inner rod and isconnected to the handle 50. Spring 25 is disposed between the proximalend of the inner rod and the proximal end of the shaft 20. Spring 25forces the inner rod against the surface of cam 37. As explained below,trigger 33 is movable by a flexion or extension of a single digitbetween a forward position and a back position. When the trigger ismoved forward, spring 25 urges inner rod distally and thus closes thejaws 18 of the instrument.

The ratchet mechanism 40 is actuated by mechanism 30 located on thehandle 50 by the mechanical thumb lever or trigger 33 which is connectedthrough a set of screws 41, 43 to the handle of the instrument. As shownin FIGS. 2-4, ratchet mechanism 40 comprises a first member 42 incommunication with a second member 44. In the “locked” positionillustrated in FIG. 2, first member 42 and second member 44 arecompletely locked to allow jaws 18 of the end effector assembly 10 to bein a “fully-open” position (FIGS. 1 and 2). To achieve this position,surface of cam 37 is designed such that the inner rod moves toward theproximal end of the instrument 100, whereby spring 25 causes the hingedjaws 18 to rotate to the “fully-open” position.

Pushing down on the mechanical thumb lever 33 of the actuating mechanism30 in the direction of arrow “A” (FIG. 3) disengages the first member 42from the second member 44 and allows the ratchet mechanism to be at an“intermediary” or “partially released” position. With the mechanicalthumb lever of the actuating mechanism 30 in the “down” position, theuser can then slide forward the mechanical thumb lever 33 in a forward,horizontal direction illustrated by arrow “B” in FIG. 4. In this manner,the first member 42 completely disengages the second member 44 andallows the ratchet mechanism to be in a “fully-released” or “fully-open”position. In turn, jaws 18 of the end effector assembly 10 are pivotedin a “closed” position to facilitate, for example, insertion of theinstrument through tissue or to allow manipulation of additionalinstrumentation at the work site.

In use, the handle 50 of the instrument is held across the palm of auser's hand in a manner similar to a pair of pliers. Advantageously, theinstrument can be held in the user's palm with the distal tip pointingaway from the body, or reversed in the palm with distal tip pointingtoward the body, affording the user greater flexibility in certainsurgical situations. The user can grip the handle and trigger in onehand without the need for a finger ring or a thumb ring on the handle ofthe instrument. The actuating mechanism is positioned for easymanipulation by the user's thumb simply by pushing down followed byflexion or extension.

FIGS. 5-7 illustrate another exemplary embodiment of a surgicalinstrument 200 provided with a handle 150 in a “wishbone configuration”and a rotary gear mechanism 140 (a rack and pinion gear mechanism) fortranslating the motion of closing and opening the handle into a rotarymotion. As with the previously-described surgical instrument 100illustrated with reference to FIGS. 1-4 above, the surgical instrument200 of FIGS. 5-7 may be employed in many surgical procedures,non-limiting examples including punching or cutting tissue duringsurgery, grasping, or manipulating and retrieving suture, among manyothers.

The surgical instrument 200 includes handle 150, a shaft 120 having aproximal end 121 and a distal end 123, and in communication with arotary gear mechanism 140. As shown in FIGS. 5 and 6, handle 150includes two operating fingers, a stationary finger 150 a (or stationaryhandle 150 a) and a movable finger 150 b (or movable handle 150 b). Whenthe movable finger 150 b is actuated, by exerting compressive pressureupon it, for example, the movable finger 150 b causes movement of therotary gear mechanism 140, which in turn actuates rotation of endeffector assembly 110.

In the exemplary embodiment shown in FIG. 5, the end effector assembly110 comprises a rotary punch 180 that pivotably rotates between an openor closed position. However, the invention is not limited to thisexemplary embodiment and the end effector assembly 110 may be part ofany surgical instrument (for example, scissors, punches or graspers,among others) that requires rotary manipulation through a handle, suchas handle 150 of the present invention.

As illustrated in FIGS. 5 and 6, handle 150 is also provided with alocking mechanism 131 provided with locking pins 132. Locking mechanism131 may engage and subsequently lock the two operating fingers 150 a,150 b when movable finger 150 b is actuated.

FIGS. 6 and 7 illustrate in more detail the rotary gear mechanism 140which is part of handle 150 of the present invention and is a rack andpinion mechanism. The rotary gear mechanism 140 comprises a rotary gearshaft 141 (which is housed by shaft 120 of the instrument 200 and isconnected to the handle 150), rotary rack 143, wishbone spring 145,reverse punch set screw 147 and handle pin 149.

The above description and drawings illustrate preferred embodimentswhich achieve the objects, features and advantages of the presentinvention. Accordingly, it is not intended that the present invention belimited to the illustrated embodiments, but only by the appended claims.

1. A surgical instrument, comprising: a shaft; an end effector assemblyat a distal end of the instrument; a handle extending from the shaft,the handle having a wishbone configuration in a plier-type arrangementand being provided with an actuating mechanism on the handle, whereinthe handle includes a movable handle and a stationary handle, themovable handle and the stationary handle being provided substantiallysymmetric relative to a longitudinal axis of the instrument; a ratchetmechanism for locking the handle, the ratchet mechanism being actuatedby the actuating mechanism, the actuating mechanism being actuatable bya user in a first direction to partially open the ratchet mechanism, andin a second direction to fully release and unlock the ratchet mechanism,the first direction being different than the second direction; and a rodextending along the shaft and linking the end effector assembly at thedistal end of the instrument to the handle.
 2. The surgical instrumentof claim 1, wherein the handle extends longitudinally from the shaft. 3.The surgical instrument of claim 1, wherein the actuating mechanismcomprises a mechanical lever adapted to be moved by a single digit. 4.The surgical instrument of claim 1, wherein the actuating mechanismincludes a cam that engages the rod.
 5. The surgical instrument of claim1, wherein the ratchet mechanism comprises a first member incommunication with a second member.
 6. The surgical instrument of claim1, wherein the instrument is an arthroscopic instrument.